Free Birth Control; Children Up to 26; Pre-Existing Conditions; Free Mammograms, etc. If these matter to you...

[umsami]

then call your Senators and Members of Congress and let them know.

 

I know many people of all political stripes who rely on these things, have adult kids on their insurance, need pregnancies covered, birth control, mammograms, etc.... so that's why I'm posting here.

 

"During the budget negotiations that took place Wednesday night, Sen. Kristen Gillibrand (D-N.Y.) penned an amendment to preserve protections for women that were created under the ACA, but it was voted down. The measure aimed to ensure that women receive birth control and mammograms without charge, required insurance companies to cover maternity care, prevented insurance companies from charging women more for preexisting conditions, and sought to even out health care costs between men and women.

 

 

"If my colleagues destroy the Affordable Care Act, it will have real, direct, and painful consequences for millions of American women and their families," Gillibrand said on the Senate floor on Wednesday.

The Senate also voted down the preexisting-conditions protection, which prevented insurance companies from considering pregnancy as a preexisting condition."

 

 

The House will vote on this tomorrow and then write their own version to send to the Senate.  If these things are important to you and your family, please make sure both your Senators and Members of Congress know that.  If you want them included in any new plan, let them know.  Make your voices heard now before it's too late.

 

Capitol Switchboard 202-224-3121

 

 

Edited January 13, 2017 by umsami

[Mama Geek]

How is this not political and by the way nothing in life is free...someone has to pay for it.

[umsami]

How is this not political and by the way nothing in life is free...someone has to pay for it.

 

I don't think health care or access to health care is political as it affects everybody, regardless if they vote or not, which party they support, even if they are citizens or immigrants. Death surely doesn't care which party you support, nor does disease.  

 

I'm very well aware of "somebody has to pay for it."  I'm married to a physician, as well as the daughter and granddaughter of physicians.  I worked for a large pharmaceutical company.  We pay a lot in taxes.  I guess we pay for somebody, but as my husband has to tell patients that their sight is not likely to come back, due to the complications of diabetes, trust me.... we'd rather increase our taxes than say that to one more person.  Most people will tell you that they'd rather die than lose their sight.  When you get to the point when your diabetes is affecting your eyes, that's not the only part of your body it's affecting.  Your kidneys are likely damaged.  You may have already had an amputation or two.  If you're a man, you probably have ED.  Go into a vitreoretinal surgeon's office and you're likely to see one or more amputees.  That's the reality of diabetes--and it's a far more difficult disease to treat when people can't afford to see even a PCP to find out that they have it.  When they find out about their diabetes because they've been taken to the ER with blood glucose levels over 450 mg/dL.  

 

My husband works in coal country in Eastern Kentucky and is very well aware of how the Affordable Care Act changed the life of people there, regardless of their political affiliations.  When people don't have insurance and cannot afford medical care, people die.  Plain and simple.  Doesn't matter if you're rich or poor, whom you voted for, your education level, etc.   My Dad is dying of leukemia right now.  The drugs that he takes cost $100k/year.  Why does he have leukemia? Probably from working 80 hours a week for 50+ years as a radiologist... serving people who could afford his services and those who could not equally.  For most of his career, being a radiologist back in the days before teleradiology meant that he would drive into the hospital often every night, sometimes more than once, when he was on call to read films, MRIs, CTs, whatever and possible save somebody's life.  Didn't matter if it was a police officer or a "bad guy", he went in.  He covered seven hospitals...some in inner cities....and some in very rural areas.  He taught numerous residents, who today also serve hundreds of thousands of people.   Do you know his political affiliation?  Maybe, maybe not.  Doesn't matter.  He'd be the first to tell you that people die when they don't have insurance.  People can go bankrupt and did even when they did have it, and that included colleagues of his.  Once again, access to health care should not be political.

 

 

But yeah...if you want to make this thread political, fine.  That was not my intent.  I just wanted people to be aware that if these things affect their families, they should take action. I guarantee you that it's not just democrats who have pre-existing conditions, or children who are in their twenties on their plans.    It's not a perfect plan by far.  But I do believe that people should be aware that these benefits that affect so many families may be removed with no replacement (and not a lot of publicity either.)  

Edited January 13, 2017 by umsami

[PeterPan]

Yeah, just on the flip side, it frustrates me to no end that I would have to pay for maternity care I don't want and can't use (because, um, hello, infertility) till I'm in my 50's just because some politician decides everyone MUST have it.

 

There really is room for more opinions. If people want policies with that stuff, let them buy it. Those of us who don't use any of that don't want to.

 

But thanks for the update. I agree, things are being done so quickly, it's hard to keep up, whether you agree with the changes or not! 

Edited January 13, 2017 by OhElizabeth

[Ailaena]

Health care should not be political.

 

And I'm torn between thanking you for alerting me to something I should know and thanking you for making me overwhelmingly frustrated.

Edited January 13, 2017 by Ailaena

[umsami]

Yeah, just on the flip side, it frustrates me to no end that I would have to pay for maternity care I don't want and can't use (because, um, hello, infertility) till I'm in my 50's just because some politician decides everyone MUST have it.

 

There really is room for more opinions. If people want policies with that stuff, let them buy it. Those of us who don't use any of that don't want to.

 

The concept of group health insurance is that healthy people, people who don't have certain conditions, pay for those who do not.  The group covers the individual.  If you could wait until you knew exactly what coverage you needed, and buy only that, then the whole concept of insurance goes out the window.  You're back to a cash pay medical system, which while fine for wealthy Americans with easily liquidable assets, are fine.  Everybody else? Kind of screwed when you have a heart attack.  In some countries, surgeons do not operate on you until a family member goes to the pharmacy and buys the supplies needed (sutures, dressings, medicines, etc.).  Don't have the money? Can't borrow it?  Sorry, you die.

 

Reality is that when people get sick, it's often not planned.  You may not be able to have a baby.... but you're still eligible for a host of diseases.  If you get breast cancer, a woman whose maternity coverage you helped pay for is paying for your chemo, your lumpectomy, etc.  If you need a knee replacement, a young person who needs birth control but whose joints are fine are helping pay for your new knee.  Say you plan on buying "breast cancer coverage" starting at 40, but unfortunately you end up with a case at 38.  That would suck, no?  My cousin is 48 and has early Alzheimer's.  Nothing she or her husband could have foreseen.  

 

Once again, ACA is not perfect.  Yet, it surprised me to read that there are people who benefit from it (such as many where my husband works) who voted to repeal "Obamacare" but didn't understand that the ACA is the same thing.  Personally, I'm for Medicare for all.  Easy to implement, takes the burden away from employers and not tied to place of employment, etc.  Medicare is an 80/20 plan, so that still leaves the door open for insurance companies to offer supplemental insurance and stay in business.  Can be paid for with a VAT or other tax.  But hey.... until there is a replacement plan, I wouldn't want somebody whose planning on getting an IUD or whose 24 year old needs surgery to find out that they're screwed.  

[TravelingChris]

Nothing is free.  Free mammograms and birth control are just added in to the cost of the insurance itself.  Then you pay higher premiums or the taxpayers pay higher premiums for you.  And yes, urging people to call to save the ACA is political.  Nothing else you can call that.

[Barb_]

How is this not political and by the way nothing in life is free...someone has to pay for it.

Well of course, that's how insurance works. Someone's cancer treatment is paid for by my decades of premiums my family has paid and hardly used. I'm happy to have it work that way. Insurance, taxes, public schools libraries, universities, roads, parks...none of these things work on a pay for play basis. The flip side is, my 22yo college student who is taking an extra year to graduate is still covered under our health insurance. And she will be when she has to live at home and intern for a year without benefits while she repays her student loans. How is that a bad thing? People who can't afford children or even regular birth control can it. How is that a bad thing? Preventing unwanted pregnancies? If my husband loses his job and health insurance and I wind up pregnant, insurance companies will be able to once again deny me insurance because pregnancy is now a pre-existing condition. How is this political?

[Barb_]

Nothing is free. Free mammograms and birth control are just added in to the cost of the insurance itself. Then you pay higher premiums or the taxpayers pay higher premiums for you. And yes, urging people to call to save the ACA is political. Nothing else you can call that.

Old, sick, and dying patients add exponentially more costs to insurance premiums. Birth control and mammograms and other preventative care are a drop in the bucket compared to Heart surgeries, brain surgeries, c-sections, neonatal care for preemies, cancer treatment, Etc--all while preventing the need to spend money on those things.

Edited January 13, 2017 by Barb_

[Audrey]

NVM. Not worth it.

 

Good luck with that, folks.

Edited January 13, 2017 by Audrey

[BusyMom5]

OhElizabeth, since my parents turned 50 they have had 3 surgeries between them (they are just 56).  Can I say that I don't want to have to pay to have your old joints worked on, all I need is maternity coverage (which is much cheaper than multiple surgeries)?  Can I say taht my BP is good, so I don't want to have to compensate toward your furture heart attack?  This is what is wrong with the whole 'Repeal ACA' cry- this isn't each man for himself, we all need to work together to help everyone cover their medical costs- both when your health is good and when it's bad.  My parents hate the ACA, but don't seem to realize they are going to be in that 'higher risk' category now- there will be no safety net to keep their coverage affordable (or as affordable as it is right now). 

[Guest]

There is no way to engage on this without violating the politics clause. The ACA was passed and some hated it. It will be canned in whole or part and others with hate that. This breaks along fairly predictable ideological lines by and large.

[regentrude]

. If people want policies with that stuff, let them buy it.

 

Let them eat cake. 

 

The only way a health insurance system that insures preexisting conditions and pregnancies can work is if all people have to participate. If only pregnant or potentially pregnant women pay for the maternity coverage, math dictates that they may as well pay directly out of pocket. If only sick people buy insurance, the burden of the sickness is distributed across the sick people only, so in effect they pay for their care. That is not insurance.

We can't have coverage of all conditions without the mandate. 

[Guest]

Yeah, just on the flip side, it frustrates me to no end that I would have to pay for maternity care I don't want and can't use (because, um, hello, infertility) till I'm in my 50's just because some politician decides everyone MUST have it.

 

There really is room for more opinions. If people want policies with that stuff, let them buy it. Those of us who don't use any of that don't want to.

 

But thanks for the update. I agree, things are being done so quickly, it's hard to keep up, whether you agree with the changes or not!

Yep, you want good maternity coverage, just cough up $2k/month and make sure you get preggers AFTER you've paid your first bill. Totes simple.

[Barb_]

There is no way to engage on this without violating the politics clause. The ACA was passed and some hated it. It will be canned in whole or part and others with hate that. This breaks along fairly predictable ideological lines by and large.

So let's stop talking about the ACA. Let's keep keep exploring whether we all understand how insurance works.

[justasque]

If you end up paying more for insurance than the insurance pays for your medical bills, you are one of the lucky ones.

 

And any of us can go from being lucky to being unlucky in the seconds it takes to be hit by 

a drunk driver, to deliver a premature baby, or to be diagnosed with a serious medical condition, all of which are largely beyond our control.


 

[BooksandBoys]

If you end up paying more for insurance than the insurance pays for your medical bills, you are one of the lucky ones.

 

And any of us can go from being lucky to being unlucky in the seconds it takes to be hit by

a drunk driver, to deliver a premature baby, or to be diagnosed with a serious medical condition, all of which are largely beyond our control.

 

 

 

So true.

My toddler was in a horrible accident. In three days, insurance paid ten times what we paid that year in premiums.

 

This makes me very happy to pay my insurance.

 

OhElizabeth, I like you a lot, but, no. The fact that you struggle with infertility does not mean you should not pay for maternity care any more than it means that I should not pay for your stroke or for your thyroid disorder. I'll happily pay into insurance so that you have coverage if YOUR child is hit by a car. I'll happily pay for your thyroid. I hope you'll consider happily paying for my dear friend's maternity costs because she keeps paying (out of pocket) to try to get pregnant. When she gets pregnant, I hope others will happily let her have maternity coverage. After all, she's been paying for thyroids and diabetes and broken bones and mental health for other people throughout her adult life.

[ChocolateReignRemix]

There is no way to engage on this without violating the politics clause. The ACA was passed and some hated it. It will be canned in whole or part and others with hate that. This breaks along fairly predictable ideological lines by and large.

 

Except the OP didn't ask anyone to call in to save the ACA.  She encouraged those who benefit from certain provisions of it, or who recognize the value of those provisions to society, to call in and express their opinion.

 

Creating a rational, functional healthcare system which can provide care for the citizens of this country shouldn't be a political issue.

[Barb_]

My 20-something daughter and her boyfriend have plans to marry when they finish college. She also was hospitalized for mental health issues over the summer. She is making great progress, but they both KNOW they shouldn't have kids until she is stabilized. She went to the health center today for an IUD appt and they put it in after a brief consult. I think they're trying to cover as much birth control as possible before the inevitable repeal. Just want to put that out there for parents of older teens and 20-somethings.

 

ETA and yes it was free. No deductible or copay.

Edited January 13, 2017 by Barb_

[maize]

I'm rather surprised that someone with a 17 year old daughter doesn't want health insurance to include maternity care as a standard...

[ChocolateReignRemix]

I'm rather surprised that someone with a 17 year old daughter doesn't want health insurance to include maternity care as a standard...

 

Nothing surprises me anymore when it comes to this issue.

[maize]

The biggest issue I see with maternity care is that it is an immense public health issue--good prenatal and obstetric care can have a positive impact on the entire future of our next generation.

 

It's like quality education--it really is a public as well as a private concern.

[Barb_]

And free birth control helps to reduce unwanted pregnancies and abortions as well as expensive neonatal charges for drug-addicted, malnourished and/or premature infants.

 

An ounce of prevention is worth a pound of cure.

[Tanaqui]

Pretty sure a thread on this topic was already locked today.

[Guest]

So let's stop talking about the ACA. Let's keep keep exploring whether we all understand how insurance works.

Most people don't seem to understand how insurance works - look at this discussion and how many people conflate medical insurance and health care, right?

[Guest]

If you end up paying more for insurance than the insurance pays for your medical bills, you are one of the lucky ones.

 

And any of us can go from being lucky to being unlucky in the seconds it takes to be hit by

a drunk driver, to deliver a premature baby, or to be diagnosed with a serious medical condition, all of which are largely beyond our control.

 

 

 

To be fair, the ACA destroying my insurance coverage saved us oodles on this nicu stay. If we had been able to continuing paying $400-500 a week on top of our enormous deductible, we still would have been on the hook for thousands of exempt expenses or those where different copay percentages were negotiated.

 

Because we had to ditch it and go with a cost sharing and no coverage guarantee, we have actually saved our family, at a minimum, $30k-50k in bills. We had lots of health care without health insurance, negotiated as a cash pay family.

 

Thanks soon to be gone Mr. President? I'm personally in the let-it-burn category and that's only strengthened since we actually had to manage hundreds of thousands in medical expenses. We were on the phone all day doing just that.

Edited January 13, 2017 by Arctic Mama

[Barb_]

Most people don't seem to understand how insurance works - look at this discussion and how many people conflate medical insurance and health care, right?

I'm not following you.

[umsami]

Pretty sure a thread on this topic was already locked today.

 

I'm sorry.  I didn't know that.  I didn't see it and I'm on a lot.  My apologies.  Really did not view this as a political discussion.

[Guest]

I'm sorry. I didn't know that. I didn't see it and I'm on a lot. My apologies. Really did not view this as a political discussion.

Generally speaking if it requires emailing elected members of congress over a highly contested piece of legislation it is, by definition, political.

[umsami]

Generally speaking if it requires emailing elected members of congress over a highly contested piece of legislation it is, by definition, political.

 

Ah, didn't know that was the agreed upon definition.

 

See for me, health care affects everybody.  Disease does not discriminate. 

[Barb_]

I brought it up earlier today and it was shut down within minutes. I've been on these boards since 1999 and for the first time ever I questioned the mods' decision to shut down a topic. When I posted, it was just FYI--this thing is passing and a lot of us will experience immediate consequences. Better have a plan in action. I'm glad to see it remain long enough to get more views because even though I read a lot of news, I still hear many things here first. More eyeballs means more awareness.

Edited January 13, 2017 by Barb_

[umsami]

I brought it up earlier today and it was shut down within minutes. I've been on these boards since 1999 and for the first time ever I questioned the mods' decision to shut down a topic. When I posted, it was just FYI--this thing is passing and a lot of us will experience immediate consequences. Better have a plan in action. I'm glad to see it remain long enough to get more views because I even though I read a lot of news, I still hear a lot of things here first. More eyeballs means more awareness.

 

Yes, I was kind of shocked...because they voted at night, etc. and I didn't hear about it until tonight when I posted (and I saw it by chance, not major coverage due to other news being more sensational, I guess).  This could affect a lot of people especially if there is no intermediary plan/grandfather plan/whatever.  

Edited January 13, 2017 by umsami

[ChocolateReignRemix]

Most people don't seem to understand how insurance works - look at this discussion and how many people conflate medical insurance and health care, right?

 

Under our current model, the two are completely intertwined for most people in the United States.  Access to medical care is directly related to the ability to pay, and for many the ability to pay is often connected to whether they have accessible insurance or not.  It would be best for us (society) to break that connection, but that is not on the table at the moment.

 

[kiwik]

Can I ask you all (all political views)? Do you think the system you have over there works for the majority (at least 90%). Can you say you have never worried yourself sick about premiums, cover, costs etc? If you were designing a system from scratch who would you model it on?

[KungFuPanda]

 

There really is room for more opinions. If people want policies with that stuff, let them buy it. Those of us who don't use any of that don't want to.

 

 

Wait. What? How do you know what disease or injury you'll get in the future? I get that you KNOW you won't get pregnant, but you can develop loads of things you never anticipated. We need insurance because we don't know. Having one person in the house incapable of getting pregnant doesn't render the household infertile.

 

It would be a little like telling you car insurance guy that you only want to be covered for collisions with other cars because you KNOW you won't have any other type of accidents.

[KungFuPanda]

Can I ask you all (all political views)? Do you think the system you have over there works for the majority (at least 90%). Can you say you have never worried yourself sick about premiums, cover, costs etc? If you were designing a system from scratch who would you model it on?

To be completely honest, it has worked for us so far despite politics and changes over the last decade. Our biggest out-of-pocket bill was the result of dental surgery not counting as "medical" (are you kidding me?) We've always had employer insurance or between-job coverage while a new policy kicked in. We have a disabled child who sees specialists and needs serious equipment. Our access to care has been immediate and the quality is high.

 

Overall, our life is comfortable, we have good doctors, and our bills are paid and our oldest is in college. However, if premiums continue to rise at this rate we'll eventually run out of money. Some people have already been priced out and this issue seems to be just creeping up the middle class income levels with no end in site.

 

To me, it just seems historically unsustainable to have a super wealthy minority while the bulk of the population carries more and more stress. There's always a breaking point when people have had enough. I'm just hoping the situation gets under control peacefully without breaking out any guillotines.

[Carrie12345]

Can I ask you all (all political views)? Do you think the system you have over there works for the majority (at least 90%). Can you say you have never worried yourself sick about premiums, cover, costs etc? If you were designing a system from scratch who would you model it on?

 

My family could be considered pretty well-to-do, statistically speaking.  There was a short time when the ACA began, when I was completely at ease with our premiums, coverage, and costs, and we didn't receive any subsidies.  Blue Cross chips away at the plans they offer every year, and now, WITH a large subsidy, we have a difficult time managing health care costs.

 

My husband is currently facing a possible cancer diagnosis.  We spend just as much time, if not more, worried about what this could do to us financially as we do worried about HIM.

 

At this point, I'd take just about any other country's model of universal health care.  I'm really not picky!

[kiwik]

Thanks. Ours is a long way off perfect (largely because the number of costly treatments available oustrips our ability to pay them) but I think my stress level regarding medical care is lower.

[Laura Corin]

Thanks. Ours is a long way off perfect (largely because the number of costly treatments available oustrips our ability to pay them) but I think my stress level regarding medical care is lower.

 

This is how it is in the UK too.

[Laura Corin]

DP

Edited January 13, 2017 by Laura Corin

[HomeAgain]

Can I ask you all (all political views)? Do you think the system you have over there works for the majority (at least 90%). Can you say you have never worried yourself sick about premiums, cover, costs etc? If you were designing a system from scratch who would you model it on?

 

I would model it on a system that is already in place.

 

I have been blessed to have had Tricare (or equiv) for 40 years now.  Our premium is low.  Our co-pay is low.  No, it's not on par with getting care at Cedar-Sinai, but I can take my kid to the emergency room when I need to.  I can get an appointment for any of us, when I need to, with doctors who care, but just like any other doctor are rushed for time.  Our doctors are paid for on a salary - they aren't in it for the big bucks.  There aren't kickbacks.  Yeah, sometimes the care is a little......wonky....but it's there.  And I can pay to see a doctor "out of network".

 

I have had my kids in both a civilian and a military hospital.  The only difference was less amenities.  I shared a room in the military hospital and didn't have access to internet.  I had good care in both. 

 

We already have a civilian counterpart to this - Medicaid/Medicare.  If we expanded it for all and did away with health insurance (which is really more like a health tax), and just gave people what they needed, we could eliminate ballooning costs.

[creekland]

My husband is currently facing a possible cancer diagnosis.  We spend just as much time, if not more, worried about what this could do to us financially as we do worried about HIM.

 

At this point, I'd take just about any other country's model of universal health care.  I'm really not picky!

 

:grouphug:  It sure seems to me that no one ought to be ending anything without replacing it with something at least as good immediately.  There are too many folks who will fall into deep cracks.  I hope you're not one of them.    :grouphug:

 

In general - not just to the poster I replied to - anyone facing medical issues (from broken bones or flu to cancer or heart disease) should not also have finances to worry about - esp when they live in a First World Country.  My post is not political.  I don't give a hoot which party gives us something.  I just feel health care, like education, should have "basics" that are free (at point of service) to all - paid for by collective taxes.  It should NOT be only available to the wealthy (or lucky).  Those who want more than the basics can pay for that the same way we pay for private schools or homeschooling or whatever.  Having a healthier nation benefits all of us.

 

We're another family who opts for Health Share (a legal option). While not technically insurance, it works similarly with a group effort to cover medical issues.  I've paid for oodles of things that don't affect our family (at the moment) - babies, transplants, kidney stones, etc.  I can't fathom only opting to pay for things that affect us.  If I had - way back when we signed up - I'd have never selected "brain tumors" as something to cover.  They simply don't run in my family on either side (no type of cancer did) and they're pretty darn rare.  I'd have signed up for cardiac and diabetic care.  Those run on both sides, so seemed obvious and they're common.  I'd have been wrong...

 

With no coverage of any sort we'd be broke, way in debt, AND I wouldn't have been able to have some of the treatments I've had including the radiation that seems to have done its job stopping tumor growth (because we couldn't afford it and the hospital wouldn't do it - that type esp - out of the goodness of their heart).

 

There are plenty of health insurance woes threads on this forum.  They aren't shut down.  It seems to me this thread is one of them unless someone starts making it partisan (and I hope they don't).  Who cares which party helps???

 

If CHIP dies, plenty of boardies could be VERY affected - as will be oodles of kids at the school where I work.

 

Don't kill ANYTHING without replacing it with something better immediately.  Real humans depend upon financial medical assistance.  No one knows who will draw the short straw and be the one needing help.  If one doesn't, consider yourself fortunate.  Personally, I'd much rather pay in and never have needs than "get my money's worth" by drawing the short straw.

Edited January 13, 2017 by creekland

[Guest]

So far, this is remaining nonpartisan (unlike the previous thread), so I'll leave it. Please abide by board rules.

 

SWB

[Pawz4me]

Can I ask you all (all political views)? Do you think the system you have over there works for the majority (at least 90%). Can you say you have never worried yourself sick about premiums, cover, costs etc? If you were designing a system from scratch who would you model it on?

 

1. No, I don't think our system works for the majority. Not at all.

 

2. I can honestly say that we've never had to worry ourselves sick or much at all, really. We've always had good insurance through employers with affordable (for us) premiums and co-pays. Note that DH has been employed by the same company for about twenty years and they're self insured. That insulates us at least somewhat. Despite our overall good experience with our current system I can easily see that it doesn't work for most and that it has many flaws and isn't sustainable.

 

3. If I were designing a system from scratch it would be Medicare for all. My experience with helping elderly relatives is that Medicare works and it works well.

[Guest]

Can I ask you all (all political views)? Do you think the system you have over there works for the majority (at least 90%). Can you say you have never worried yourself sick about premiums, cover, costs etc? If you were designing a system from scratch who would you model it on?

I never worried before ACA. We had major medical (an 80/20 plan) when I was young, and HMOs by the time I was married. Costs were reasonable, And it worked like auto insurance...everything covered if something major happened, or one was diabetic etc. as long as you didnt need experimental care. Now the pols have decided 9.5% of annual income is a reasonable cost. There is coinsurance on diagnostics and surgery, which is hitting people hard. The high deductibles have meant that tax payers pick up the costs...most of the local Govts around here taxed the citizens in order to give their employees the cash for the annual deductible, while the citizens who have nongovt employer insurance weren't that lucky. Its now common to have public fundraisers for things that used to be covered, like first round cancer treatment, because people just don't have that much cash saved up for the high deductible and all the co-insurance. Pre ACA, fundraisers would be for housing modification, to accommodate a person who needed an accessible home, such as a wounded vet or police officer .

 

What I want is the cadillac plan that I pay for through my school taxes, And I want price discrimination to end.

Edited January 13, 2017 by Heigh Ho

[The Girls' Mom]

Thank you, SWB.  I hope everyone plays nice.

 

Even though we've been fairly lucky in the insurance department, I think a single payer system is what is needed, with upgrade options for those that wish to pay for it.  Providing free basic healthcare for the masses would only benefit the country as a whole.  I have relatives that go without very necessary treatment because they cannot afford it.  Medications are crazy expensive, and we've often had to weigh my dh's pain management against the cost of it.  Or my dd's asthma meds (although we've never considered NOT paying for those because they are a life or death issue) I can't imagine how hard it is for people that have to chose between their next meal or their medical needs.  For that reason alone, I'm willing to pay into a system that covers things like that for all.  

 

As far as what is going on in the House right now, no matter how you feel about the ACA, they need to tread carefully.  These decisions impact the most fragile of our citizens the most.  There has to be careful thought put into it, and it isn't something that can be simply gutted without some sort of scaffolding to hold together the things that the poorest and sickest of us need the most.  

[PeterPan]

The concept of group health insurance is that healthy people, people who don't have certain conditions, pay for those who do not.  

 

 

 

Wait. What? How do you know what disease or injury you'll get in the future? I get that you KNOW you won't get pregnant, but you can develop loads of things you never anticipated. We need insurance because we don't know. Having one person in the house incapable of getting pregnant doesn't render the household infertile.

 

It would be a little like telling you car insurance guy that you only want to be covered for collisions with other cars because you KNOW you won't have any other type of accidents.

 

I don't think there's any disagreement on the obvious point that group participation has to be there across ages for insurance to work. The disagreement is the nature of the groups. And fwiw, everything you listed was catastrophic care. I already have a policy for catastrophic and have had it for years and years. Everything you listed is covered. It also includes routine annual care like mammograms, vaccines, etc. We got it before the law change, and it was very affordable. 

 

I don't think there's any disagreement that americans need and want affordable access to catastrophic level coverage. However we're leaping from wanting everyone to have access to catastrophic coverage to saying everyone ought to have premium coverage of everyday issues. Those are totally separate things and that's something they're debating. I would say I don't WANT to be on Medicare. I want low premiums and catastrophic coverage with an HSA to pay cost of things toward my deductible. I LIKE the coverage I had, and I'm really excited that they're debating lifting the cap on HSA contributions. This would allow people the choice to have high deductible, catastrophic policies (to cover the issues like cancer, that we all agree happen!) and yet keep costs down.

 

It's hard stuff.

Edited January 13, 2017 by OhElizabeth

[Guest]

Thanks. Ours is a long way off perfect (largely because the number of costly treatments available oustrips our ability to pay them) but I think my stress level regarding medical care is lower.

Health insurance has always been a huge stressor for us and it has set us back 10 years financially.

 

DH has a heart issue. For years, he could only work at a place that offered insurance because it was the only way he could get it. We paid thousands/year in insurance when we were just stating our and it was crippling.

 

Enter the ACA. We were finally able to shop on the open market. We saved $1k/month for a year. Then insurance costs started rising and there were fewer policies to pick from.

 

This year we're paying $900/month for the worst insurance ever. Over half of our doctor aren't covered, huge deductible. Fingers crossed for a healthy year!!

 

Health shares are not the answer. We tried.

 

It makes my blood boil to think about how we've struggled and then see the salaries of insurance execs. No vacations, no college savings for my kids, nothing extra and some *itch takes home millions a month. More money than she can spend. F*ck this system.

Edited January 13, 2017 by Moxie

[Laura Corin]

I don't think there's any disagreement that americans need and want affordable access to catastrophic level coverage. However we're leaping from wanting everyone to have access to catastrophic coverage to saying everyone ought to have premium coverage of everyday issues.

 

Isn't it a good idea to catch things before they become catastrophic?  If one has to pay out of pocket for the less serious things, isn't one more likely to ignore the minor that turns out to be a symptom of something major, allowing it to worsen?

[LifeLovePassion]

Part of the problem to me is the lack of transparency of the part of providers about cost. I tried calling to get info on what a big evaluation would cost and couldn't get a direct answer from any providers office. As a consumer, I feel this information should be more available so I can choose for myself the balance of cost vs provider.

 

I did it for my granite counters (got many estimates. Prices ranged from $3,500-5,000.) So why shouldn't I be able to find it out before doing a medical appointment, evaluation, lab test or x-ray.

 

The second problem is with crazy billing practices and disallows. My sister in law had a line item the other day that was $1200 for a blood test. It was disallowed down to $90.Over 90% discount. It is such a broken system.